Background: This study was performed to evaluate the effects of initial periodontal treatment on clinical periodontal measurements, glycemic control, and systemic inflammatory mediator levels in patients with type 2 diabetes and chronic periodontitis.
Methods: Thirteen well-controlled (glycated hemoglobin [HbA1c] <7%) and 12 poorly controlled (HbA1c > or =7%) patients with type 2 diabetes and chronic periodontitis and 15 systemically healthy patients with chronic periodontitis were enrolled. Blood samples were collected at baseline from all patients and 1 and 3 months after the initial periodontal treatment from patients with diabetes. Serum levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, C-reactive protein (CRP), soluble intercellular adhesion molecule-1, adiponectin, and leptin were analyzed by enzyme-linked immunosorbent assay.
Results: The study groups showed similar improvements in clinical periodontal variables at all evaluation times (P <0.05). HbA1c levels in the poorly controlled group with diabetes decreased significantly at 3 months after completion of the initial periodontal treatment (P <0.05), whereas no significant changes were evident in the well-controlled group. There were insignificant decreases in TNF-alpha and CRP levels (P >0.05). IL-6 levels decreased in well-controlled patients with diabetes and in the systemically healthy group (P <0.05). Adiponectin levels increased in the systemically healthy group (P <0.05). Leptin levels increased at 1 month in well-controlled patients with diabetes (P <0.05).
Conclusions: Within the limits of this study, patients with type 2 diabetes and chronic periodontitis exhibited similar clinical periodontal improvements as their systemically healthy counterparts. Initial periodontal treatment appeared to improve glycemic control in poorly controlled patients with diabetes. Decreases in levels of IL-6, TNF-alpha, CRP, and leptin and an increase in adiponectin levels after periodontal therapy may be a function of glycemic control in patients with type 2 diabetes.